21 |
Registered Nurse Job Satisfaction and Nursing LeadershipLibano, Maria Candida 01 January 2017 (has links)
Job dissatisfaction among nurses may contribute to disengagement and withdrawal from the profession. The degree of leadership support in the workplace influences job satisfaction, and when nurses are satisfied with their job, they provide better patient care. Guided by the social cognitive theory, which asserts a relationship between behavior change and one's surroundings, this quantitative, exploratory project sought to determine the type of nursing leadership practiced in the facility where the project took place, whether nurses were satisfied with their job, and if patients were satisfied with their care. Participants in the project included 55 registered nurses and 5 nurse managers. Three surveys of demographics, job satisfaction, and leadership styles were administered to 60 RN participants; patient satisfaction data were obtained from the hospital's last reported Hospital Consumer Assessment of Healthcare Providers and Systems survey. Descriptive statistics from the nurse surveys showed 75% were female, 56.7% had a bachelor's degree, and, most were under the age of 50 years. Results showed that 90.8% of nurses enjoyed working for the hospital, leaders primarily used transformational leadership styles, and 80.2 to 89.7% of patients were satisfied with their care. This project has implications for positive social change because healthy, transformative leadership leads to staff satisfaction and improved patient satisfaction.
|
22 |
Mental Health Therapists' Perceptions of the Relationship between Client Gender and Personal Characteristics which Contribute to Successful Therapeutic ExperiencesMeyer, Denise R. January 2012 (has links)
No description available.
|
23 |
The Influence of Client Socioeconomic Status on Counselors' Attributional Biases and Objective Countertransference ReactionsDougall, Jennifer Lara 20 May 2010 (has links)
No description available.
|
24 |
L’évaluation du raisonnement clinique des résidents en hématologie par l’approche de concordance de scriptBestawros, Alain 01 1900 (has links)
La pratique de l’hématologie, comme celle de toute profession, implique l’acquisition d’un
raisonnement adéquat. Se basant sur une théorie de psychologie cognitive, le test de
concordance de script (TCS) a été développé et validé comme un instrument permettant
d’évaluer le raisonnement clinique dans diverses spécialités médicales. Le but de cette
étude était d’examiner l’utilité et les paramètres psychométriques d’un TCS en
hématologie. Nous avons construit un TCS composé de 60 questions que nous avons
administré à 15 résidents juniors (R1 à R3 en médecine interne), 46 résidents séniors (R4,
R5 et R6 en hématologie) et 17 hématologues à travers le Canada. Après optimisation, le
TCS comptait 51 questions. Sa consistance interne mesurée par le coefficient de Cronbach
alpha était 0.83. Le test était en mesure de discriminer entre les résidents selon leur niveau
de formation. Les questions contenant des images (n=10) semblaient avoir un potentiel
discriminatoire plus élevé. Les scores obtenus par les résidents séniors corrélaient
modéremment avec ceux obtenus à un test conventionnel d’hématologie composé de
questions à choix multiples et à courte réponse (r de Pearson = 0.42; p=0.02). Le TCS a été
complété en 36 minutes en moyenne et a été bien reçu par les participants. Le TCS est un
instrument d’évaluation utile et valide en hématologie. Il peut être utilisé à des fins
formatives en aidant au suivi de la progression des résidents. Il pourrait aussi être combiné
à d’autres instruments d’évaluation à des fins sanctionnelles, ou encore, en éducation
médicale continue. / The practice of hematology, like any other profession, requires the acquisition of adequate
judgment. Based on cognitive psychology theory, the script concordance test (SCT) has
been developed and validated as an instrument capable of evaluation clinical judgement in
various medical specialties. The goal of this study was to examine the usefulness and the
psychometric qualities of the SCT in hematology. We constructed a SCT composed of 60
questions and we administered it to 15 junior residents (R1 to R3 in internal medicine), 46
senior residents (R4, R5 and R6) and 17 hematologists from across Canada. After item
optimization, the test comprised 51 questions. Its internal consistency measured by
Cronbach alpha was 0.83. The test was able to discriminate between residents according to
their year of training. Questions containing an image (n=10) seemed to offer a stronger
discriminative potential. Scores obtained by the senior residents correlated moderately with
those obtained on a conventional hematology exam made of multiple choice questions and
short-answers (Pearson r: 0.42; p=0.02). The SCT was completed in an average of 36
minutes and was well received by participants. The SCT is a useful and valid evaluation
instrument in hematology. It may be used during training to monitor resident progression. It
may also be combined to other evaluation tools and used for summative purposes or in
continuing medical education.
|
25 |
Cuidar de si, cuidar do outro - programa de aprimoramento do raciocínio clínico / Take care of yourself, take care of the other - program of improvement of clinical reasoningCerullo, Josinete Aparecida da Silva Bastos 31 March 2009 (has links)
Esta pesquisa teve como finalidade permitir a expressão das características do diagnosticador, a fim de que ele próprio reconhecesse como suas características pessoais influenciam suas decisões clínicas. OBJETIVOS: Testar um programa de formação permanente, baseado em histórias de vida, para o aprimoramento do raciocínio clínico em enfermagem; descrever os temas presentes nos processos cognitivos e metacognitivos dos participantes, desencadeados pelas estratégias do programa; analisar a influência das estratégias do programa sobre o raciocínio clínico dos participantes; descrever as intervenções realizadas pelas pesquisadoras. MÉTODO: Planejamento e execução de pesquisa-formação em três hospitais e uma escola de enfermagem de São Paulo, Brasil. Os dados foram constituídos pelas produções escritas dos participantes e pelas observações das pesquisadoras, anotadas em diário. Esses dados foram interpretados a partir da análise de seus conteúdos, com base em proposições teóricas sobre raciocínio clínico e sobre histórias de vida e formação. RESULTADOS: O programa foi implementado com um grupo de 7 enfermeiras de um hospital geral universitário e com dois grupos (um com 7 e outro com 6) de estudantes de graduação em enfermagem. Nos três grupos houve 8 encontros semanais em que ocorreram análises de textos, avaliações de saúde, estudos de caso de pacientes, escritas e partilhas das histórias de vida e projetos. Os temas recuperados com o programa referiram-se aos domínios afetivo e cognitivo. As participantes realizaram e refletiram sobre a coleta e interpretação de informações, elaboraram julgamentos clínicos, analisaram dilemas ético-morais e significados sobre o cuidado de si e dos outros. CONCLUSÕES: As reflexões sobre o autocuidado e as próprias histórias de vida (cuidado de si) permitiram às participantes reavivarem as múltiplas influências que as formam, e que formam os outros, e dinamizaram conhecimentos, habilidades e atitudes necessárias em suas relações com os usuários do sistema de saúde, colegas de trabalho e profissão (cuidado de outros) / The present study intended to enable the expression of the characteristics of diagnosing professionals, so that they could acknowledge to what extent personal characteristics could influence their clinical decisions. OBJECTIVES: To test a program of permanent training, based on life histories, to improve clinical reasoning in nursing; to describe the topics present in cognitive and metacognitive processes of participants, triggered by program strategies; to analyze the influence of program strategies over clinical reasoning of participants; to describe the interventions used by the researchers. METHOD: Planning and execution of the research program and training in three hospitals and one nursing school in Sao Paulo, Brazil. Data consisted of the writing productions of participants and the observations of the researchers, registered in diaries. Data were interpreted by analyzing the content based on theoretical assumptions about clinical reasoning and life histories and training. RESULTS: The program was implemented in a group of 7 nurses in a general university hospital and in two groups (7 and 6 members, respectively) of undergraduate nursing students. The three groups had 8 weekly meetings where they analyzed texts, healthcare examinations, case studies, written pieces and shared life histories and projects. The topics retrieved by the program comprised the affective and cognitive domains. Participants performed and reflected about the collection and interpretation of information, made clinical judgments, analyzed ethical-moral dilemmas, and the meanings of taking care of others and of themselves. CONCLUSIONS: Reflections about self-care and their own life histories (taking care of themselves) enabled the participants to revive the multiple influences that had formed them and had formed the others. They could maximize knowledge, skills and attitudes required to their relationships with healthcare users, co-workers and the profession (taking care of the others)
|
26 |
Language in clinical reasoning: using and learning the language of collective clinical decision makingLoftus, Stephen Francis January 2006 (has links)
Doctor of Philosophy / The aim of the research presented in this thesis was to come to a deeper understanding of clinical decision making from within the interpretive paradigm. The project draws on ideas from a number of schools of thought which have the common emphasis that the interpretive use of language is at the core of all human activity. This research project studied settings where health professionals and medical students engage in clinical decision making in groups. Settings included medical students participating in problem-based learning tutorials and a team of health professionals working in a multidisciplinary clinic. An underlying assumption of this project was that in such group settings, where health professionals are required to articulate their clinical reasoning for each other, the individuals involved are likely to have insights that could reveal the nature of clinical decision making. Another important assumption of this research is that human activities, such as clinical reasoning, take place in cultural contexts, are mediated by language and other symbol systems, and can be best understood when investigated in their historical development. Data were gathered by interviews of medical students and health professionals working in the two settings, and by non-participant observation. Data analysis and interpretation revealed that clinical decision making is primarily a social and linguistic skill, acquired by participating in communities of practice called health professions. These communities of practice have their own subculture including the language game called clinical decision making which includes an interpretive repertoire of specific language tools and skills. New participants to the profession must come to embody these skills under the guidance of more capable members of the profession, and do so by working through many cases. The interpretive repertoire that health professionals need to master includes skills with words, categories, metaphors, heuristics, narratives, rituals, rhetoric, and hermeneutics. All these skills need to be coordinated, both in constructing a diagnosis and management plan and in communicating clinical decisions to other people, in a manner that can be judged as intelligible, legitimate, persuasive, and carrying the moral authority for subsequent action.
|
27 |
Language in clinical reasoning: using and learning the language of collective clinical decision makingLoftus, Stephen Francis January 2006 (has links)
Doctor of Philosophy / The aim of the research presented in this thesis was to come to a deeper understanding of clinical decision making from within the interpretive paradigm. The project draws on ideas from a number of schools of thought which have the common emphasis that the interpretive use of language is at the core of all human activity. This research project studied settings where health professionals and medical students engage in clinical decision making in groups. Settings included medical students participating in problem-based learning tutorials and a team of health professionals working in a multidisciplinary clinic. An underlying assumption of this project was that in such group settings, where health professionals are required to articulate their clinical reasoning for each other, the individuals involved are likely to have insights that could reveal the nature of clinical decision making. Another important assumption of this research is that human activities, such as clinical reasoning, take place in cultural contexts, are mediated by language and other symbol systems, and can be best understood when investigated in their historical development. Data were gathered by interviews of medical students and health professionals working in the two settings, and by non-participant observation. Data analysis and interpretation revealed that clinical decision making is primarily a social and linguistic skill, acquired by participating in communities of practice called health professions. These communities of practice have their own subculture including the language game called clinical decision making which includes an interpretive repertoire of specific language tools and skills. New participants to the profession must come to embody these skills under the guidance of more capable members of the profession, and do so by working through many cases. The interpretive repertoire that health professionals need to master includes skills with words, categories, metaphors, heuristics, narratives, rituals, rhetoric, and hermeneutics. All these skills need to be coordinated, both in constructing a diagnosis and management plan and in communicating clinical decisions to other people, in a manner that can be judged as intelligible, legitimate, persuasive, and carrying the moral authority for subsequent action.
|
28 |
Probability distortion in clinical judgment : field study and laboratory experiments / Distorsion de probabilité dans le jugement clinique : étude de terrain et expériences en laboratoireHainguerlot, Marine 21 December 2017 (has links)
Cette thèse étudie la distorsion de probabilité dans le jugement clinique afin de comparer le jugement des médecins à des modèles statistiques. Nous supposons que les médecins forment leur jugement clinique en intégrant une composante analytique et une composante intuitive. Dans ce cadre, les médecins peuvent souffrir de plusieurs biais dans la façon dont ils évaluent et intègrent les deux composantes. Cette thèse rassemble les résultats obtenus sur le terrain et en laboratoire. À partir de données médicales, nous avons constaté que les médecins n'étaient pas aussi bons que les modèles statistiques à intégrer des évidences médicales. Ils surestimaient les petites probabilités que le patient soit malade et sous-estimaient les probabilités élevées. Nous avons constaté que leur jugement biaisé pourrait entraîner un sur-traitement. Comment améliorer leur jugement? Premièrement, nous avons envisagé de remplacer le jugement du médecin par la probabilité de notre modèle statistique. Pour améliorer la décision, il était nécessaire d'élaborer un score statistique qui combine le modèle analytique, la composante intuitive du médecin et sa déviation observée par rapport à la décision attendue. Deuxièmement, nous avons testé en laboratoire des facteurs qui peuvent influencer le traitement de l'information. Nous avons trouvé que la capacité des participants à apprendre la valeur de la composante analytique, sans feedback externe, dépend de la qualité de leur composante intuitive et de leur mémoire de travail. Nous avons aussi trouvé que la capacité des participants à intégrer les deux composantes dépend de leur mémoire de travail, mais pas de leur évaluation de la composante intuitive. / This thesis studies probability distortion in clinical judgment to compare physicians’ judgment with statistical models. We considered that physicians form their clinical judgment by integrating an analytical component and an intuitive component. We documented that physicians may suffer from several biases in the way they evaluate and integrate the two components. This dissertation gathers findings from the field and the lab. With actual medical data practice, we found that physicians were not as good as the statistical models at integrating consistently medical evidence. They overestimated small probabilities that the patient had the disease and under estimated large probabilities. We found that their biased probability judgment might cause unnecessary health care treatment. How then can we improve physician judgment? First, we considered to replace physician judgment by the probability generated from our statistical model. To actually improve decision it was necessary to develop a statistical score that combines the analytical model, the intuitive component of the physician and his observed deviation from the expected decision. Second, we tested in the lab factors that may affect information processing. We found that participants’ ability to learn about the value of the analytical component, without external feedback, depends on the quality of their intuitive component and their working memory. We also found that participants’ ability to integrate both components together depends on their working memory but not their evaluation of the intuitive component.
|
29 |
Cuidar de si, cuidar do outro - programa de aprimoramento do raciocínio clínico / Take care of yourself, take care of the other - program of improvement of clinical reasoningJosinete Aparecida da Silva Bastos Cerullo 31 March 2009 (has links)
Esta pesquisa teve como finalidade permitir a expressão das características do diagnosticador, a fim de que ele próprio reconhecesse como suas características pessoais influenciam suas decisões clínicas. OBJETIVOS: Testar um programa de formação permanente, baseado em histórias de vida, para o aprimoramento do raciocínio clínico em enfermagem; descrever os temas presentes nos processos cognitivos e metacognitivos dos participantes, desencadeados pelas estratégias do programa; analisar a influência das estratégias do programa sobre o raciocínio clínico dos participantes; descrever as intervenções realizadas pelas pesquisadoras. MÉTODO: Planejamento e execução de pesquisa-formação em três hospitais e uma escola de enfermagem de São Paulo, Brasil. Os dados foram constituídos pelas produções escritas dos participantes e pelas observações das pesquisadoras, anotadas em diário. Esses dados foram interpretados a partir da análise de seus conteúdos, com base em proposições teóricas sobre raciocínio clínico e sobre histórias de vida e formação. RESULTADOS: O programa foi implementado com um grupo de 7 enfermeiras de um hospital geral universitário e com dois grupos (um com 7 e outro com 6) de estudantes de graduação em enfermagem. Nos três grupos houve 8 encontros semanais em que ocorreram análises de textos, avaliações de saúde, estudos de caso de pacientes, escritas e partilhas das histórias de vida e projetos. Os temas recuperados com o programa referiram-se aos domínios afetivo e cognitivo. As participantes realizaram e refletiram sobre a coleta e interpretação de informações, elaboraram julgamentos clínicos, analisaram dilemas ético-morais e significados sobre o cuidado de si e dos outros. CONCLUSÕES: As reflexões sobre o autocuidado e as próprias histórias de vida (cuidado de si) permitiram às participantes reavivarem as múltiplas influências que as formam, e que formam os outros, e dinamizaram conhecimentos, habilidades e atitudes necessárias em suas relações com os usuários do sistema de saúde, colegas de trabalho e profissão (cuidado de outros) / The present study intended to enable the expression of the characteristics of diagnosing professionals, so that they could acknowledge to what extent personal characteristics could influence their clinical decisions. OBJECTIVES: To test a program of permanent training, based on life histories, to improve clinical reasoning in nursing; to describe the topics present in cognitive and metacognitive processes of participants, triggered by program strategies; to analyze the influence of program strategies over clinical reasoning of participants; to describe the interventions used by the researchers. METHOD: Planning and execution of the research program and training in three hospitals and one nursing school in Sao Paulo, Brazil. Data consisted of the writing productions of participants and the observations of the researchers, registered in diaries. Data were interpreted by analyzing the content based on theoretical assumptions about clinical reasoning and life histories and training. RESULTS: The program was implemented in a group of 7 nurses in a general university hospital and in two groups (7 and 6 members, respectively) of undergraduate nursing students. The three groups had 8 weekly meetings where they analyzed texts, healthcare examinations, case studies, written pieces and shared life histories and projects. The topics retrieved by the program comprised the affective and cognitive domains. Participants performed and reflected about the collection and interpretation of information, made clinical judgments, analyzed ethical-moral dilemmas, and the meanings of taking care of others and of themselves. CONCLUSIONS: Reflections about self-care and their own life histories (taking care of themselves) enabled the participants to revive the multiple influences that had formed them and had formed the others. They could maximize knowledge, skills and attitudes required to their relationships with healthcare users, co-workers and the profession (taking care of the others)
|
30 |
Schopnost posouzení závažnosti osobnostní psychopatologie na základě Strukturovaného interview organizace osobnosti (STIPO) u magisterských studentů adiktologie / Ability to assess the severity of personality psychopathology based on the Structured Interview of Personality Organization (STIPO) in master students of addictologyRiegel, Karel Dobroslav January 2021 (has links)
Background: With the development of multidisciplinary addictology teams, the ability of an addictologist to reliably assess personality psychopathology can be considered an important prerequisite that significantly enters the process of treatment planning. Because the addictologist is often the first professional to come into contact with the client, verification of the accuracy of clinical judgment seems to be one of the key indicators of addictologist competence. Aims: Verification of the reliability and validity of the clinical assessment of personality psychopathology in master students of addictology based on the course on scoring the Structured Interview of Personality Organization (STIPO). Methods: 31 master students of addictology independently evaluated 7 protocols of the STIPO on the basis of recordings. The presented patients were unknown to the students. Data was collected as part of the STIPO scoring course. The resulting scores of students were compared with: 1. the expert scores of a clinical psychologist with many years of experience with the STIPO; 2. the scores of 4 other psychologists without previous experience with the STIPO who attended the course; 3. information on previous clinical experience and previous education of the students. The comparison of scores was performed by...
|
Page generated in 0.0543 seconds